Lesotho Red Cross Society

The Lesotho Red Cross Society was granted $609,216 over a period of 3 years to develop and test an outreach model that will harness the efforts of Senkatana ART Centre and Red Cross clinics that will define a most affordable essential health package for breast and cervical cancer in 3 districts of Lesotho.

Need

Non-communicable diseases (NCDs) have steadily increased in Lesotho in the last two decades. The most prominent NCDs are hypertension, cardiovascular diseases, diabetes mellitus and cancers, especially reproductive health-related cancers (i.e. cervix, breasts and prostate). For this reason, Lesotho instituted a program for non-communicable diseases in 2000 to obtain more information and determine the risk factors in order to address prevention and control.

Cervical cancer is the most common cancer in Lesotho, with 40 -49 year olds, accounting for 40.9% of all cancers. Cervical cancer is followed by breast cancer (18%), prostate cancer (13.5%), skin cancer (12.6%), lung cancer (no estimates and commonly found on autopsy) and leukemia/lymphomas (no estimates). The above statistics illustrate that reproductive health cancers are the most prevalent in the country.

A desktop baseline study conducted in the country has also established that 40% of people with AIDS develop cancer due to suprressed immune systems and increased susceptibility to infection by oncogenic viruses. Lesotho has an HIV and AIDS prevalence of 23% for adults (Lesotho Demographic Health Survey 2004), with 27% prevalence of women in childbearing age. This is a high percentage of HIV infection and also contributes to the high incidence of cancer. Cervical cancer is the leading cause of cancer death among women in Lesotho; 40% of all women who are diagnosed with cervical cancer in Lesotho present with advanced disease.

To date there is no referral or cancer treatment centre in Lesotho. Cervical cancer has been the single largest cause for referral from Queen Elizabeth II (QEII), the former national referral hospital, to Bloemfontein. In 2006-2007, cervical cancer accounted for 34% of all cancer referrals, costing government a huge financial burden of over 10 million maloti/rands (over 1 million USD) to treat. Sadly, the patients are relatively young (44% under 50 and 65% under 60 years of age), and the majority of the referrals are for late stage disease with high mortality. Breast cancer referrals follow at 14%, and often these cases are seen at late stages and the outcome of management given is therefore unsatisfactory in terms of progress to reasonable health and living.

The majority (73%) of the population of 1.8 million people live in rural areas. The highlands are associated with rural settlements due to their geographical setting which makes them remote and usually very hard to reach areas. Majority of the population is isolated and only has access to poor health facilities/services if any at all.

Project

Lesotho Red Cross Society aims to build the capacity of health care workers for comprehensive screening and treatment of both NCDs and communicable diseases, as well as educate community groups and health workers about these diseases and their care. The project includes screening services provided through mobile clinics for hard-to-reach rural communities and building an outreach model that is affordable and accessible.

The goal is to reduce the burden of communicable and non-communicable diseases and increase early detection through screenings. Operational research and feedback from the community will also provide affordable and accessible service packages that can be duplicated throughout the country.

The project shall be based in Maseru, Berea and Mokhotlong, which are three of the ten districts in Lesotho. The areas where the project shall focus within these three districts are mostly rural areas.